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COVID-19 大流行期间结构性心脏病介入治疗转诊患者的分诊考虑:ACC/SCAI 立场声明。

Triage Considerations for Patients Referred for Structural Heart Disease Intervention During the COVID-19 Pandemic: An ACC/SCAI Position Statement.

机构信息

American College of Cardiology Interventional Cardiology Section Leadership Council, Washington, DC; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

American College of Cardiology Interventional Cardiology Section Leadership Council, Washington, DC; Cardiovascular Division, University of Utah Health, Salt Lake City, Utah.

出版信息

JACC Cardiovasc Interv. 2020 Jun 22;13(12):1484-1488. doi: 10.1016/j.jcin.2020.04.001. Epub 2020 Apr 6.

Abstract

The coronavirus disease-2019 (COVID-19) pandemic has strained health care resources around the world, causing many institutions to curtail or stop elective procedures. This has resulted in an inability to care for patients with valvular and structural heart disease in a timely fashion, potentially placing these patients at increased risk for adverse cardiovascular complications, including CHF and death. The effective triage of these patients has become challenging in the current environment as clinicians have had to weigh the risk of bringing susceptible patients into the hospital environment during the COVID-19 pandemic against the risk of delaying a needed procedure. In this document, the authors suggest guidelines for how to triage patients in need of structural heart disease interventions and provide a framework for how to decide when it may be appropriate to proceed with intervention despite the ongoing pandemic. In particular, the authors address the triage of patients in need of transcatheter aortic valve replacement and percutaneous mitral valve repair. The authors also address procedural issues and considerations for the function of structural heart disease teams during the COVID-19 pandemic.

摘要

新型冠状病毒病 2019(COVID-19)大流行已经使世界各地的医疗资源紧张,导致许多机构减少或停止了选择性手术。这导致无法及时为瓣膜性和结构性心脏病患者提供治疗,这些患者可能面临更大的心血管不良并发症风险,包括心力衰竭和死亡。在当前环境下,对这些患者进行有效的分诊变得具有挑战性,因为临床医生必须权衡在 COVID-19 大流行期间将易感患者带入医院环境的风险与延迟必要手术的风险。在本文件中,作者提出了如何对需要结构性心脏病介入治疗的患者进行分诊的指南,并提供了一个框架,说明如何在持续大流行的情况下决定何时进行干预可能是合适的。特别是,作者讨论了需要经导管主动脉瓣置换术和经皮二尖瓣修复术的患者的分诊。作者还讨论了结构性心脏病团队在 COVID-19 大流行期间的程序问题和考虑因素。

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